January 4, 2011 — The contaminated hands of anesthesia providers are a significant source of patient environmental and stopcock set contamination in the operating room, according to the results of a study by Randy W. Loftus, MD, from Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, and colleagues, reported in the January 2011 issue of Anesthesia & Analgesia.
"As anesthesiologists, we like to think that the surgical drapes protect the patient from tens of trillions of microorganisms that are in and on our bodies," said editor-in-chief of Anesthesia & Analgesia Steven L. Shafer, from Columbia University in New York, NY, in a news release. "Nope! These studies provide evidence that our bacterial flora contribute to surgical site infections."
The hypothesis tested by this study was that bacterial contamination of anesthesia provider hands before patient contact is a risk factor for direct intraoperative bacterial transmission. At Dartmouth-Hitchcock Medical Center, a tertiary care and level 1 trauma center with 400 inpatient beds and 28 operating suites, the first and second operative cases in each of 92 operating rooms were randomly selected for analysis.
The results of the study were that intraoperative bacterial transmission occurred in 11.5% (19/164) of cases, of which 47% (9/19) were of provider origin. Intraoperative bacterial transmission to the anesthesia environment occurred in 89% (146/164) of cases, 12% (17/146) of which were of provider origin.
The investigators were quoted as saying: "Although we know that hand-washing is an important step, our compliance is poor, and there is little excuse for hospitals not implementing systems that facilitate compliance with hand-washing guidelines," Dr. Shafer said. "However, as [this report suggests], it is time to look at additional measures to protect our patients from the biofilm that we take into the operating room every day."
